Individual provider Active NPI

Richard Moorman, LCSW

  • Clinical Social Worker
  • Franklin Park, IL
National Provider Identifier
1346665841
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.015578 Issued in IL
Practice address
10200 Grand Ave
Franklin Park, IL 60131-3139
Phone
(847) 455-5688
Fax
(847) 455-0744
NPI assigned
Feb 20, 2014
Last updated
Feb 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.015578 IL Primary

Addresses

Primary practice location

10200 Grand Ave
Franklin Park, IL 60131-3139

Mailing address

10200 W. Grand Aveune
Franklin Park, IL 60131
Phone (847) 455-5688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140516001702 IL Practitioner - Clinical Social Worker 2769605849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

191 Waukegan Rd
Suite 206
Northfield, IL 60093-2743
Phone (847) 251-7350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.015578ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Center of Wilmette Glenview Northbrook Kenilworth Clinical CurrentSince Nov 9, 2022 Accepting new patients
Leyden Family Service & Mental Health Center Past Accepting new patients

Locations

191 Waukegan Rd
Ste 206
Northfield, IL 60093
Phone (847) 251-7350

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1346665841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 W. GRAND AVEUNE",
            "city": "FRANKLIN PARK",
            "state": "IL",
            "postal_code": "60131",
            "telephone_number": "847-455-5688",
            "fax_number": "847-455-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 GRAND AVE",
            "city": "FRANKLIN PARK",
            "state": "IL",
            "postal_code": "601313139",
            "telephone_number": "847-455-5688",
            "fax_number": "847-455-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORMAN",
        "first_name": "RICHARD",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-20",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Park, IL

Sources for this page

Verify at the official NPI Registry.